摘要
目的:探讨瑞舒伐他汀联合阿奇霉素治疗慢性阻塞性肺疾病(COPD)合并肺动脉高压(PAH)临床疗效及对患者血管内皮功能、血清D二聚体及N末端B型脑钠肽前体(NT-proBNP)的影响。方法:选取芜湖市第一人民医院2017年6月~2022年8月COPD合并PAH患者102例,按照随机抽样法分为观察组和对照组各51例。对照组在常规疗法上给予阿奇霉素治疗,观察组在对照组基础上给予瑞舒伐他汀治疗。比较两组治疗前和治疗30 d后动脉血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、肺动脉平均压(mPAP)、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、降钙素原(PCT)、趋化因子配体18(CCL-18)、血管紧张素转化酶(ACE)、低密度脂蛋白(LDL-C)、血管内皮生长因子(VEGF)、中性粒细胞弹性蛋白酶(NE)、血浆不规则趋化因子(FKN)、NT-proBNP、血清D二聚体的差异。结果:两组患者治疗30 d后PaO_(2)水平均上升(P<0.05),观察组高于同期对照组(P<0.05);PaCO_(2)、mPAP、TNF-α、IL-1β、CCL-18、PCT、ACE、LDL-C、VEGF、FKN、血清D二聚体、NT-proBNP、NE水平较治疗前下降(P<0.05),观察组低于对照组(P<0.05)。两组患者治疗过程中仅有1例出现恶心、头晕,两组均未出现肝功能损害等其他不良反应。结论:瑞舒伐他汀联合阿奇霉素治疗COPD合并PAH效果显著优于阿奇霉素单用,可更有效缓解炎症,促进血管内皮及肺部功能恢复,减少不良反应发生概率,安全性较强。
Objective:To investigate the clinical efficacy of rosuvastatin plus azithromycin in treating chronic obstructive pulmonary disease(COPD)patients concomitant with pulmonary arterial hypertension(PAH)and the effects of this medication regimen on vascular endothelial function and serum levels of D-dimer and N-terminal pro-B-type brain natriuretic peptide(NT-proBNP).Methods:One hundred and two COPD patients with PAH treated in our hospital were included from June 2017 to August 2022,and randomized to observational group and control group(n=51 for each group).Patients in control group received azithromycin based on routine therapy,and those in observational group were given additional rosuvastatin besides the medication regimen in the control group.The two groups were compared for the difference before and 30 days after treatment pertinent to PaO_(2),PaCO_(2),and mean pulmonary arterial pressure(mPAP),inflammatory factors(tumor necrosis factorα,TNF-α;interleukin-1β,IL-1β;procalcitonin,PCT;and chemokine ligand 18,CCL-18),vascular endothelial function indicators[angiotensin converting enzyme(ACE),low-density lipoprotein cholesterol(LDL-C),and vascular endothelial growth factor(VEGF)and disease-related serum biochemical indicators(neutrophil elastase,NE;plasma fractalkine,FKN;NT-proBNP,and serum D-dimer).Results:After 30 days of treatment,the PaO_(2) level was increased in both groups of patients(P<0.05),and the increase was significant in observational group compared to the control group(P<0.05).PaCO_(2),mPAP,TNF-α,IL-1β,CCL-18,PCT,ACE,LDL-C,VEGF,FKN,serum D-dimer,NT-proBNP and NE were notably decreased in both groups following treatment,yet the decrease was dominant in the observational group(all P<0.05).Only one patient was complicated with nausea and dizziness,and no adverse reactions such as liver function damage were observed in either group.Conclusion:Rosuvastatin plus azithromycin for COPD patients with PAH is significantly superior to single dose of azithromycin.This combined medication regimen can more effectively relieve inflammation,promote the recovery of vascular endothelial and pulmonary function,and reduce the incidence of adverse reactions,making it a safer and more effective treatment option.
作者
王芳
李超
张军
张硕
张娇娇
WANG Fang;LI Chao;ZHANG Jun;ZHANG Shuo;ZHANG Jiaojiao(Department of Respiratory Medicine,Wuhu No.1 People′s Hospital,Wuhu 241000,Anhui,China)
出处
《皖南医学院学报》
CAS
2024年第5期449-453,共5页
Journal of Wannan Medical College
基金
芜湖市科技项目(2022jc80)。
关键词
阿奇霉素
瑞舒伐他汀
慢性阻塞性肺疾病
肺动脉高压
血管内皮功能
血清D二聚体
N末端B型脑钠肽前体
azithromycin
rosuvastatin
chronic obstructive pulmonary disease
pulmonary arterial hypertension
vascular endothelial function
serum D-dimer
N-terminal pro-B-type brain natriuretic peptide
